Irritable bowel syndrome

Background

  1. psychosocial factors
  2. altered gut motility
  3. hypersensitive intestinal pain perseption

Evaluation

Criteria

  1. Three months of pain:
    1. relieved by defecation
    2. associated with change of stool freq
    3. related to a change in stool consistency
  2. AND, 2 or more of the following symptoms 25% of the time
    1. >3 bm per day or < 3 bm per week
    2. altered stool form
    3. altered stool passage
    4. passage of mucous
    5. bloating

Workup

  • Diagnosis of exclusion

Differential Diagnosis

Management

  • Consider prescribing ondansetron up to 24 mg/d for IBS-D[1]
  • Typical bowel regimen treatments for IBS-C
    • May consider low-dose TCA if appropriate follow up with PCP will occur

See Also

External Links

Patient Information

Irritable Bowel Syndrome (National Digestive Diseases Information Clearinghouse)

References

  1. Garsed K, Chernova J, Hastings M, et al. A randomised trial of ondansetron for the treatment of irritable bowel syndrome with diarrhoea. Gut. 2014;63:1617-1625.